Operative surgery, for students and practitioners . s (A) have beenseparated from the other structures of the cord—from the spermatic artery andpampiniform plexus (B). Ligatures have been tied about B above and belowpreparatory to excising the intervening portion. rated from the vas deferens, etc., are tied, one above and the otherbelow. The portion intervening is excised with the scissors, not tooclose to the ligatures, and the ends of the ligatures, which have beenpurposely left long, are then tied together, in this way bringing theends of both stumps into apposition. The ends of these two p
Operative surgery, for students and practitioners . s (A) have beenseparated from the other structures of the cord—from the spermatic artery andpampiniform plexus (B). Ligatures have been tied about B above and belowpreparatory to excising the intervening portion. rated from the vas deferens, etc., are tied, one above and the otherbelow. The portion intervening is excised with the scissors, not tooclose to the ligatures, and the ends of the ligatures, which have beenpurposely left long, are then tied together, in this way bringing theends of both stumps into apposition. The ends of these two portionsmay be still further secured by one or two catgut sutures, whichshould take a good Inte through the whole thickness of each stump. The portion of the cord which is stripped away from the vasdeferens, and which is ligated and excised, is composed of all theveins of the pampiniform plexus and the spermatic artery. Whenthe ^as is isolated, the artery of the vas deferens, which anastomoses OPERATIONS UPON THE SPERMATIC CORD, SCROTUM, ETC. 641. Fig. 292.—^Varicocele. Cord separated into two segments. Finger andthumb of left hand grasp vas and adjacent vessels, artery and veins, of vasdeferens. Finger and thumb of right hand grasp spermatic artery and veins ofpampiniform plexus. 642 HERNIA, ETC. below with the spermatic artery, and the cremasteric artery, togetherwith their corresponding veins, go with it; these vessels are there-fore not interfered with, and they are sufficient to provide for thenutrition of the testis after the pampiniform plexus and the sper-matic artery have been ligated. For the ligatures, plain catgTit, not too thick (Xo. 1 or 2), maybe used, and special care should be taken to apply the upper ligaturesecurely that it may not slip, as this would result in a very free hem-orrhage from the end of the spermatic arter}^ In this operation one not only ties off the veins of the pam-piniform plexus, but also shortens the cord, and thus draws the testisup, a
Size: 1653px × 1511px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
